<include file="Public/base"/>
<!--表单-->
<div class="pd-20">
    <form action="" method="post" class="form form-horizontal" id="submitForm">
        <div class="row cl">
            <label class="form-label col-3">疾病名称</label>
            <div class="formControls col-5">
                <input type="text" class="input-text" name="disease_name" value="{$disease_name}" required id="disease_name">
            </div>
        </div>
        <div class="row cl">
            <label class="form-label col-3">科室分类</label>
            <div class="formControls col-5">
                <select name="section_office_id" class="input-text" id="section_office_id">
                    <option value="" <if condition="$section_office_id eq ''">selected</if>>无</option>
                    <volist name="keshi" id="vo">
                       <option value="{$vo.id}" <if condition="$vo.id eq $section_office_id">selected</if>>{$vo.type_name}</option>
                    </volist>
                </select>
            </div>
        </div>
        <div class="row cl">
            <label class="form-label col-3">人群分类</label>
            <div class="formControls col-5">
                <select name="crowd_id" class="input-text" id="crowd_id">
                    <option value="" <if condition="crowd_id eq ''">selected</if>>无</option>
                    <volist name="renqun" id="vo">

                        <option value="{$vo.id}" <if condition="$vo['id'] eq $crowd_id">selected</if>>{$vo.type_name}</option>
                    </volist>
                </select>
            </div>
        </div>
        <div class="row cl">
            <label class="form-label col-3">概述</label>
            <div class="formControls col-5">
                <textarea name="summary" id="summary" style="margin: 0px; height: 66px; width: 341px;" required>{$summary}</textarea>
            </div>
        </div>
        <div class="row cl">
            <label class="form-label col-3">病因</label>
            <div class="formControls col-5">
                <textarea name="disease_reason" id="disease_reason" style="margin: 0px; height: 66px; width: 341px;" required>{$disease_reason}</textarea>
            </div>
        </div>
        <div class="row cl">
            <label class="form-label col-3">临床表现</label>
            <div class="formControls col-5">
                <textarea name="clinical_manifestations" id="clinical_manifestations" style="margin: 0px; height: 66px; width: 341px;" required>{$clinical_manifestations}</textarea>
            </div>
        </div>
        <div class="row cl">
            <label class="form-label col-3">并发症</label>
            <div class="formControls col-5">
                <textarea name="complication" id="complication" style="margin: 0px; height: 66px; width: 341px;" required>{$complication}</textarea>
            </div>
        </div>
        <div class="row cl">
        <label class="form-label col-3">实验室检查</label>
        <div class="formControls col-5">
            <textarea name="laboratory_check" id="laboratory_check" style="margin: 0px; height: 66px; width: 341px;" required>{$laboratory_check}</textarea>
        </div>
    </div>
        <div class="row cl">
            <label class="form-label col-3">诊断</label>
            <div class="formControls col-5">
                <textarea name="diagnosis" id="diagnosis" style="margin: 0px; height: 66px; width: 341px;" required>{$diagnosis}</textarea>
            </div>
        </div>
        <div class="row cl">
            <label class="form-label col-3">治疗</label>
            <div class="formControls col-5">
                <textarea name="treatment" id="treatment" style="margin: 0px; height: 66px; width: 341px;" required>{$treatment}</textarea>
            </div>
        </div>
        <div class="row cl">
            <label class="form-label col-3">预防</label>
            <div class="formControls col-5">
                <textarea name="prophylaxis" id="prophylaxis" style="margin: 0px; height: 66px; width: 341px;" required>{$prophylaxis}</textarea>
            </div>
        </div>
        <div class="row cl">
            <label class="form-label col-3">是否为常见疾病</label>
            <div class="formControls col-5">
                <label><input type="radio" name="is_common" value="0" <if condition="$is_common eq 0">checked="checked"</if> /> 否</label> &nbsp;
                <label><input type="radio" name="is_common" value="1" <if condition="$is_common eq 1">checked="checked"</if> /> 是</label>
            </div>
        </div>
        <div class="row cl">
            <label class="form-label col-3">排序</label>
            <div class="formControls col-5">
                <input type="text" class="input-text" name="sort" placeholder="默认为0" value="{$sort}" required id="sort">
            </div>
        </div>
        <div class="row cl">
            <div class="col-9 col-offset-3">
                <input type="hidden" name="id" id="id" value="{$id}">
                <button class="btn btn-primary radius" id="submit" type="submit">确 定</button>
                <button class="btn btn-warning radius" onclick="history.back(-1);return false;">返 回</button>
            </div>
        </div>
    </form>
</div>
<!--引入js,css-->
<script type="text/javascript" src="__STATIC__/common/js/func.js"></script>
<script type="text/javascript" src="__STATIC__/common/js/add.js"></script>
<script type="text/javascript" src="__STATIC__/common/js/laydate/laydate.js"></script>
<link type="text/css" href="__STATIC__/uploadify/uploadify.css" rel="stylesheet"/>
<script type="text/javascript" src="__STATIC__/uploadify/jquery.uploadify.min.js"></script>
<script type="text/javascript">
    //验证相关
    var validate_rules = {};
    var validate_messages = {};
</script>